James Forsyth

NHS delays could derail Boris’s re-election campaign

NHS delays could derail Boris's re-election campaign
(Photo by Carl Court/Getty Images)
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What is the biggest single threat to the Tories being re-elected? The NHS waiting list, I say in the Times today. Already more than five million people are waiting for routine hospital treatment in England. Sajid Javid has warned that this number could rise to 13 million — which would be one in four of the population.

Simon Stevens, the just-departed head of NHS England, has warned that this waiting list could take three years to clear which takes you right up to the next election. For Labour, the backlog list offers the easiest and most comfortable of attack lines: 'You can’t trust the Tories with the NHS'. If millions are stuck waiting for treatment, this line will have huge resonance.

Fear of the waiting list is why the Tories are prepared to break their manifesto pledge and raise National Insurance. Although the funds raised will eventually go towards the social care cap that Boris Johnson is keen to introduce, it will initially provide money to help clear the backlog. It is a sign of the size of the problem that there’s no certainty in Whitehall that even the £10 billion a year raised by a penny increase for both employees and employers will provide sufficient funds.

It is, though, worth noting that more money doesn’t necessarily translate into more capacity. The limiting factor is the number of doctors and nurses. In past years, this would simply mean recruiting more staff from abroad. New Labour did this. In 2001 16,000 nurses and midwives joined the register from abroad. Close to a third of doctors working in the NHS in 2003 had qualified abroad. It helped cut waiting lists. But it is far harder to do this now, not because of Brexit, which has had little effect on NHS staffing, but because there is a global shortage of medical staff. The world is two million doctors short of the number it needs, says the World Health Organisation. This means that there is going to have to be a particular emphasis on changes that can make the health service more efficient if this backlog is going to get cleared.